1. Field of the Invention
The invention relates generally to a device and method for mandibular fixation. More particularly, the present invention relates to a two-state, high-surface contact area, rapid-cure, bondable-support bracket brace and fiber strap and a method for its use.
2. Description of Related Art
The current art of managing maxillomandibular fractures is based on securing an arch bar to immobilize fracture segments. Known arch bars are designed to provide stabilization of fractures of the maxilla, the mandible, or both. The original arch bar was an ordinary round bar, eventually modified to include a bar, flattened on one side.
For over a decade, bonded arch bars have been used in maxillomandibular trauma, reconstruction, and various other oral surgical procedures. The prefabricated, one-piece, metal, mesh-backed arch bar for direct bonding is commercially available. The device is malleable enough to be contoured to the buccal tooth surface yet firm enough to withstand the forces that tend to displace it. Other than the addition of a metal mesh backing, these direct bonding arch bars are similar to the modified arch bar.
Bonded arch bars of this design have had limited success. The metal mesh increased surface contact marginally. In addition to low-holding forces, the sharp metal mesh was dangerous and required multiple epoxy applications, numerous tools, and considerable skill to apply.
Through the years, many different methods of fixing arch bars have been developed. The most popular method of fixing arch bars is via interdental wires. Plastic cable ties, disclosed in U.S. Pat. No. 5,613,853 to Chasan et al, bone screws and direct bonding have also been used with limited success.
Periodental injury is always a threat with interdental wires or cables because the wires must be placed below the gingival margins to guarantee stability. With the inherent difficulty of maintaining proper oral hygiene and the necessity to penetrate the interdental papilla with the large profile circumdental wire or strap, gingival inflammation and damage are expected. Any implants are also expected to suffer damage. Moreover, the use of interdental wires typically results in gum bleeding, which increases the likelihood of the transmission of diseases, such as hepatitis and HIV, to the surgeon. Additionally, the open wounds caused by the interdental wires increase the possibility of infection to the patient.
Bone screws in the maxilla and mandible, linked by a loop of wire, have also been described. This method, however, is not applicable to all fractures, although it does reduce the risk of skin puncture associated with passing interdental wires.